Effects of Sickle Trait on Maternal and Perinatal Outcomes of Pregnant Women

1. Women with SCT had higher risk of PRHD and UTI, but lower risk of LBW

2. SCT not linked to PRHD, but increased risk of UTI & lower LBW risk

The risk of multiple adverse pregnancy outcomes and perinatal outcomes among pregnant women with sickle cell trait (SCT) is not known. Our objective was to compare differences in adverse outcomes, specifically pregnancy-related hypertensive disease (PRHD), pyelonephritis/urinary tract infection (UTI) and low birth weight (LBW) between pregnant women with SCT and healthy controls.

This was a retrospective cohort study of women who delivered between 2015 and 2020. We included all women with SCT i.e. hemoglobin electrophoresis AS (HbAS). Women with SCT were matched in a 1:2 to women without SCT matched by age, gravidity, and parity. Our primary outcomes were PRHD, pyelonephritis/UTI and LBW baby. Multivariable logistic regression modeling examined associations between patients’ characteristics and the primary outcomes.

There were 162 women with SCT, and 324 healthy control women were enrolled. Bivariate analysis revealed that women with SCT had a higher proportion of PRHD (38.9% vs. 34.9%, p=0.39), pyelonephritis/UTI (11.7% vs. 7.1%, p=0.09) but a lower proportion of low birth weight (10.5% vs. 16.0%, p=0.1). In multivariable analysis, after controlling for confounders, SCT was not an independent predictor of PRHD. However, SCT was an independent predictor of pyelonephritis/UTI aOR 1.98 (95% C.I. 1.02 – 3.85) and an independent predictor of a lower risk of having a LBW baby aOR 0.48 (95% CI 0.25 – 0.94).

SCT is not associated with an increased risk of PRHD. However, SCT is associated with pregnancy outcomes, including higher risk of pyelonephritis/UTI, but a lower risk of low birth weight babies.